Journal of general internal medicine · 2008
Stop orders to reduce inappropriate urinary catheterization in hospitalized patients: a randomized controlled trial.
СтатьяМногоцентровое исследованиеРандомизированное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Loeb Mark, Hunt Derek, O'Halloran Kelly, Carusone Soo Chan, Dafoe Nancy, Walter Stephen D
Аннотация
BACKGROUND: Hospitalized patients frequently have urinary catheters inserted for inappropriate reasons. This can lead to urinary tract infections and other complications.
OBJECTIVE: To assess whether stop orders for indwelling urinary catheters reduces the duration of inappropriate urinary catheterization and the incidence of urinary tract infections.
DESIGN: A randomized controlled trial was conducted in three tertiary-care hospitals in Ontario, Canada. Patients with indwelling urinary catheters were randomized to prewritten orders for the removal of urinary catheters if specified criteria were not present or to usual care.
PARTICIPANTS: Six hundred ninety-two hospitalized patients admitted to hospital with indwelling urinary catheters inserted for < or = 48 h.
MEASUREMENTS: The main outcomes included days of inappropriate indwelling catheter use, total days of catheter use, frequency of urinary tract infection, and catheter reinsertions.
RESULTS: There were fewer days of inappropriate and total urinary catheter use in the stop-order group than in the usual care group (difference -1.69 [95% CI -1.23 to -2.15], P < 0.001 and -1.34 days, [95% CI, -0.64 to -2.05 days], P < 0.001, respectively). Urinary tract infections occurred in 19.0% of the stop-order group and 20.2% of the usual care group, relative risk 0.94 (95% CI, 0.66 to 1.33), P = 0.71. Catheter reinsertion occurred in 8.6% of the stop-order group and 7.0% in the usual care group, relative risk 1.23 (95% CI, 0.72 to 2.11), P = 0.45.
CONCLUSIONS: Stop orders for urinary catheterization safely reduced duration of inappropriate urinary catheterization in hospitalized patients but did not reduce urinary tract infections.
OBJECTIVE: To assess whether stop orders for indwelling urinary catheters reduces the duration of inappropriate urinary catheterization and the incidence of urinary tract infections.
DESIGN: A randomized controlled trial was conducted in three tertiary-care hospitals in Ontario, Canada. Patients with indwelling urinary catheters were randomized to prewritten orders for the removal of urinary catheters if specified criteria were not present or to usual care.
PARTICIPANTS: Six hundred ninety-two hospitalized patients admitted to hospital with indwelling urinary catheters inserted for < or = 48 h.
MEASUREMENTS: The main outcomes included days of inappropriate indwelling catheter use, total days of catheter use, frequency of urinary tract infection, and catheter reinsertions.
RESULTS: There were fewer days of inappropriate and total urinary catheter use in the stop-order group than in the usual care group (difference -1.69 [95% CI -1.23 to -2.15], P < 0.001 and -1.34 days, [95% CI, -0.64 to -2.05 days], P < 0.001, respectively). Urinary tract infections occurred in 19.0% of the stop-order group and 20.2% of the usual care group, relative risk 0.94 (95% CI, 0.66 to 1.33), P = 0.71. Catheter reinsertion occurred in 8.6% of the stop-order group and 7.0% in the usual care group, relative risk 1.23 (95% CI, 0.72 to 2.11), P = 0.45.
CONCLUSIONS: Stop orders for urinary catheterization safely reduced duration of inappropriate urinary catheterization in hospitalized patients but did not reduce urinary tract infections.